Objective To observe the morphological characteristics of congenital optic disc pit with maculopathy, the natural de-velopment, and changes after laser photocoagulation. Design Retrospective case series. Participants Twelve cases with congenital optic disc pit. Methods Records of 12 patients with congenital optic disc pit with maculopathy were reviewed. Clinical examination includes optical coherence tomography (OCT), color fundus photography, and fluorescein angiography (FA). The data was analyzed with the exist-ing theory of pathogenesis of the disease. Main Outcome Measures Visual acuity and morphology of macupopathy. Results All the patients were noted to have serous maculopathy associated with optic disc pit. Serous detachment of neuro-retina was found in two pa-tients, schisis of neuro-retina in two patients, and both serous detachment and schisis of nearo-retina were observed in other patients. Two patients were associated with choroidal coloboma. Four patients were treated with laser photocoagulation, in which 3 patients had vision improved. Conclusions Schisis and detachment of neuro-retina are the important morphologic changes of congenital optic disc pit with maculopthy. Proper understanding of the relationship between the development of the disease and these changes will be helpful to study its pathogenesis. Patients may benefit in part from laser photocoagulation. (Ophthalmol CHN, 2009, 18: 233-236)

ObjectiveTo observe in vivo segmental lumbar motion in patients with lumbar disc herniation (LDH) during functional weight-bearing activities.MethodsFifteen patients with LDH at L4-5 were studied as experimental group.Ten healthy volunteers were recruited as control group.Three-dimension(3D) lumbar spine models of L3,L4 and L5 were reconstructed from thin section CT scans.Spine motions were then reproduced by matching lumbar spine models and images got from dual fluoroscopic imaging system (DFIS)under different motion state (standing,flexion-extension,left-right twisting and left-right bending).From local coordinate systems at the end plates,the motion of the cephalad vertebrae relative to the caudal vertebrae was calculated for vertebrae levels:L4-5 and L3-4.ResultsThe motion pattern at L4-5 was found to be altered.During flexion-extension,the migrations of the affected segments along the frontal axis,sagittal axis,vertical axis were similar with that of the control group,but the rotation angle along the frontal axis was significantly larger than that of the control group (P＜0.05).During left-right bending and left-right twisting,the migration and rotation angle along the frontal axis were significantly larger than those of control group.During flexionextension,the migrations of the neighboring segments (L3-4) along the three axes were larger than those of the control group,but there were no statistical significances.During left-right bending and left-right twisting,the migrations of the neighboring segments (L3-4) along the vertical axis were significantly larger than those of the control group (P＜0.05).ConclusionThe 3D lumbar motion pattern in LDH patient is different with that of normal people.For the affected segment,compared with the normal people,the range of flexion-extension motion and the translocation in left-right direction were significantly larger,but the rotation range along the vertical axis was smaller.

Objective To determine the incidence and risk factors of iatrogenic retinal breaks in eyes undergoing pars plana vit- rectomy for idiopathic macular pucker.Design Retrospective case series.Participant 88 consecutive vitrectomies performed on eyes with idiopathic macular pucker.Method Consecutive vitrectomies performed on eyes with idiopathic macular pucker at Beijing Tongren Eye Center between 2002 and 2006 were retrospectively reviewed.Cases with iatrogenic retinal breaks were recorded and analyzed. Main Outcome Measure Number and location of retinal breaks,and anatomic outcome after surgical managements.Result A total of 88 consecutive vitrectomies were included in the study.Of the 88 eyes,8 eyes had 14 iatrogenic retinal breaks detected,with an aver- age incidence of 9.1%.Peripheral retinal breaks(8.0%)were more common than posterior retinal breaks(1.1%).All peripheral retinal breaks occurred around the selerotomy sites(100%)and the quadrant of predominant hand was involved most commonly(62%).Most of the breaks(88%)were detected during the surgery.All eyes with iatrogenic retinal breaks obtained anatomic retinal reattachment (100%).Conclusion Despite improvements in instrumentation and surgical techniques,iatrogenic retinal break continues to be an im- portant complication of pars plana vitrectomy in eyes with idiopathic macular pucker.This complication tends to occur more commonly at peripheral retina and is mainly selerotomy-related.

OBJECTIVETo observe the effect of combination of Syndrome Differentiation (SD) depending treatment and chemotherapy on prognostic factors in patients with non-small cell lung cancer (NSCLC).

METHODSOne hundred and twenty patients with NSCLC were randomly divided into the TCM group, the western medicine (WM) group and the combined TCM and WM (TCM-WM) group. Besides the conventional supporting and symptomatic treatment given to all the 3 groups, to the TCM group, Chinese drug medication according to patients' SD (intravenons injection, decoction or Xiaoji Decoction) was given, to the WM group chemorherapy was given, and to the TCM-WM group, all the treatment used in both TCM and WM group were given. The long-term efficacy was analyzed by Kaplan-Meier method, the 24 prognostic factors that influencing survival rate were analyzed by COX regression model multiple factors analysis to screen the risk factor and protective factor.

RESULTSThe median survival period in the TCM group was 285.00 +/- 17.92 days, in the WM group was 265.00 +/- 1.80 days, insignificant difference was found between them (P > 0.05), that in the TCM-WM group was 359.00 +/- 7.00 days, which was longer than that in the above two groups with significance (P < 0.05). The half-year and 1-year survival rates in the TCM group were 84.4% and 18.1%, in the WM group 82.5% and 20.6%, and in the TCM-WM group 92.5% and 42.7%. The 1-year survival rate in the TCM-WM group was higher than that in the TCM and WM group with significant difference (P < 0.05). Analysis on 24 prognostic factors indicated that there was significant difference (P < 0.05) in influence of such factors on survival rate as clinical stage, lymph node invasion, complications, TCM Syndrome typing, lactate dehydrogenase, carcinoembryonic antigen (CEA), CA199, Karnofsky scoring before treatment, therapeutic method, total scores of quality of life, stability of treatment, CD3+, etc. The former seven were the risk factors for prognosis of midlate NSCLC patients, and the latter 5 the protective factors.

CONCLUSIONTCM-WM treatment could prolong patients' survival period, elevate the long-term survival rate, it could be taken as one of the best comprehensive therapies for mid-late NSCLC patients who have missed the opportunity of surgical resection.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cisplatin ; administration & dosage ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Drugs, Chinese Herbal ; therapeutic use ; Etoposide ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Prognosis ; Regression Analysis

In vitro electrical neurophysiological and behavioural studies have shown that diabetes mellitus negatively affects hippocampal function. In this study, by using in vivo extracellular recording, the spontaneous neural activity was obtained from hippocampus of anaesthetized rats in both streptozotocin-induced diabetes group and normal control group. Temporal relationship between neuronal firing and slow oscillation (1-4 Hz) of local field potentials (LFPs) in hippocampus was analyzed using coherence and phase locking measurement. Lower coherence value (0.617+/-0.028) was observed in diabetic rats than that in control rats (0.730+/-0.024) (P=0.005). Furthermore, phase-locking measurement using von Mises fitting parameterized by a concentration parameter kappa showed a lower degree (kappa= 0.347+/-0.113) of temporal coordination between neuronal spiking and slow oscillation of LFPs in the hippocampus of diabetic rats than that of normal ones (kappa= 1.174+/-0.134) (P<0.001). Both approaches demonstrated that diabetes can indeed impair the temporal coordination between neuronal spiking and slow oscillation of population activity in hippocampus. This observed neural coordination impairment may serve as a network level mechanism for diabetes-induced memory deterioration.
Action Potentials ; Animals ; Diabetes Mellitus, Experimental ; physiopathology ; Hippocampus ; physiopathology ; Memory ; Oscillometry ; Rats

OBJECTIVETo study the clinical efficacy and adverse reaction of comprehensive therapy mainly with Chinese anti-cancer medicinal perfusion/embolization and assisted with Chinese drug-therapy based on TCM Syndrome Differentiation in treating primary liver cancer.

METHODSForty-one patients with liver cancer were divided into the treated group and the control group. To the treated group turmeric oil microballoon, cinobufotalin, Aidi injection and iodized oil were given via hepatic artery perfusion/embolization, and to the control group chemotherapeutic agents and iodized oil were given for instead. Besides, both groups were given Chinese herbs according to TCM Syndrome Differentiation additionally.

RESULTSThe tumor inhibitory rate in the treated group and the control group was 77.78% and 69.57% respectively, with insignificant difference between them. The improvement of fatigue and anorexia in the treated group was better than that in the control group (P < 0. 05). The 6-month, 12-month and 24-month survival rate in the treated group and control group was 61.11% vs 56.62%, 27.78% vs 30.43% and 22.22% vs 26.09%, respectively, the difference between the two groups was insignificant. The occurrence of adverse reactions such as decreasing of white blood cells, platelet and hemoglobin, nausea and vomiting were obviously lower in the treated group than those in the control group (P < 0.05).

CONCLUSIONChinese anti-cancer medicinal perfusion/embolization has affirmative short-term clinical effect in treating primary liver cancer with few adverse reactions, which was tolerable to patients, but its long-term clinical efficacy needs further observation.

Adult ; Aged ; Antineoplastic Agents, Phytogenic ; administration & dosage ; Carcinoma, Hepatocellular ; drug therapy ; therapy ; Chemoembolization, Therapeutic ; methods ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy

Objective To investigate the effect of intravenous fluid infusion combined with water throuth gastrointestinal tract in treating the patients with hyperosmolar hyperglycemic state(HHS).Methods 30 HHS pa- tients were recruited.All the patients were given water throuth gastrointestinal infusion while they were administrat- ed continuously intravenous infusion.Laboratory parameters such as serum natrium,serum potasium,serum glucose and serum osmolarity ect were monitored at the admission and after treatment.Results Serum glucose and serum osmolarity of HHS patients were decreased smoothly at the speed of less than 3 mmol?L~(-1).h~(-1)during the first 12 hours after treatment.After 48 hour-treatment,serum natrium,serum potassium and serum osmolarity recovered to normal levels except 2 deaths,serum glucose decreased to(10.8?5.2)mmol/L.Conclusion Intravenous fluid infu- sion combined with water throuth gastrointestinal tract for the patients could lower smoothly serum glucose and serum osmolarity and decrease the mortality of the HHS patients.

OBJECTIVE: To investigate and analyze the changes of postmortem human biochemical indexes. METHODS: Subclavian venous blood samples were collected from 81 cases of traffic fatalities. Thirteen blood biochemical indexes including liver function (ALT, AST, TBIL and DBIL), renal function (UA and Cr), cardiac function (CK, CK-MB and LDH), electrolytes (K+, Na+ and Cl-), and glucose (GLU) were tested by Roche cobas c311 automatic biochemical analyzer. The descriptive analysis was made by SPSS 17.0 statistical software. RESULTS: The values of ALT, AST, CK, CK-MB, LDH and K+ were higher than normal reference values with more fluctuations. The values of TBIL, DBIL, UA, Cr, Na+, Cl- and GLU were relatively stable with less fluctuations. CONCLUSION The postmortem human blood biochemical indexes of liver function, renal function, cardiac function, electrolytes and glucose could be affected by the factors, especially hemolysis and autolysis. The biochemical indexes, particularly enzymes, increased significantly with higher standard deviation.
Accidents, Traffic/mortality* ; Autopsy ; Blood Chemical Analysis/methods* ; Heart Function Tests ; Humans ; Kidney Function Tests ; Liver Function Tests ; Reference Values

OBJECTIVETo improve the paramedian forehead flap for nasal reconstruction.

METHODSBased on the findings of the Cutaneous branch of supratrochlear artery, the forehead musculo-cutaneous flap was divided into the musculo-flap and the skin-flap in 3 patients. The musculo-flap were used to reconstruct the septi-bone structure, and envelop silicon nasal-frame, while the skin-flap were used to reconstruct the nose. In 6 patients, the forehead flap was used as a skin-flap just with the muscle pedicle to reconstruct a nose with good appearance of nasal subunits, without the secondary operation.

RESULTSIn all of 9 cases, the cutaneous-branch of supratrochlear artery was found 1.7-2.0 cm above the orbital-rim. Eight patients got good results, only 1 patient had to do the secondary operation to coverage the exposed nasal frame.

CONCLUSIONSThe cutaneous-branch of supratrochlear artery could be an anatomical finding to form the forehead skin-flap and it is a good choice to be used to reconstruct a nose, even in complicated cases.

Adolescent ; Adult ; Female ; Forehead ; Humans ; Male ; Muscles ; transplantation ; Nose ; surgery ; Patient Satisfaction ; Reconstructive Surgical Procedures ; methods ; standards ; Skin Transplantation ; methods ; Surgical Flaps ; Treatment Outcome

OBJECTIVETo study the effect of laparoscopy combined with endoscopic and digital subtraction angiography in the treatment of severe acute pancreatitis (SAP).

METHODSNine-seven SAP patients were randomly divided into group A (n=32) with conventional treatment and group B (n=35) with combined treatment with laparoscopy, endoscopic and digital subtraction angiography in addition to the conventional treatment. The clinical indices and therapeutic effects in the 2 groups were compared.

RESULTSAfter treatment, the patients in group B had significantly lower APACHE score than those in group A (P<0.05), with also better hepatic, renal and lung functions (P<0.05). The serum TNF-alpha and IL-1beta levels was significantly lower, but IL-10 significantly higher in group B (P<0.05). The CT SPN was significantly lowered in group B as compared with that in group A (P<0.05). The patients in group B had significantly lower rate of organ failure (P<0.01) and higher successful rate in organ failure management (P<0.05), with also lowered inhospital mortality than those in group A (P<0.05).

CONCLUSIONLaparoscopy combined with endoscopic pancreaticobiliary duct drainage and digital subtraction angiography in addition to conventional treatment significantly improves the outcome and decreases the mortality of SAP patients.

Angiography, Digital Subtraction ; Endoscopy, Digestive System ; Female ; Humans ; Interleukin-1beta ; blood ; Kidney ; physiopathology ; Laparoscopy ; Liver ; physiopathology ; Male ; Middle Aged ; Multiple Organ Failure ; Pancreatitis ; blood ; diagnostic imaging ; pathology ; surgery ; Treatment Outcome ; Tumor Necrosis Factor-alpha ; blood